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Refractory Celiac Disease Responds to Stem Cell Transplant

Jefferson Adams

Jefferson Adams is a freelance writer living in San Francisco. His poems, essays and photographs have appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate among others.

He is a member of both the National Writers Union, the International Federation of Journalists, and covers San Francisco Health News for Examiner.com.

Celiac.com 04/10/2007 - Patients suffering from refractory
celiac disease with aberrant T cells seem to benefit from high-dose chemotherapy
followed by autologous hematopoietic stem cell transplantation. Refractory
celiac disease with aberrant T cells has generally proven resistant to
known celiac therapies, and patients are at high risk for developing enteropathy
associated T-celllymphoma. The small pilot trial was conducted by Dr.
Abdulbaqi Al-toma and colleagues from VU University Medical Center, Amsterdam.

The study followed seven patients whose mean average
age was 52.5 years old at the time of the procedure, and followed them
for an average of 15.5 months (the lowest follow-up time was 7 months,
the longest was 30 months). According to the study, there was no transplantation-related
mortality, and only mild cases of transplantation-related toxicity. A
one-month post-procedure follow-up showed remarkable clinical improvement
all patients, including disappearance of abdominal pain, normalization
of stool frequency, and improvement of biochemical markers.

The research team also noted that post-transplant histology
of the small intestine revealed marked regeneration coupled with a disappearance
of erosions and ulcerations. Furthermore, at 3 to 4 months, post-transplantation
tests showed a decline in aberrant T cells from a mean of 63% at baseline
to 38%. Additionally, at 2 years, tests for the first hematopoietic stem
cell transplant patient showed continuing declines in aberrant T cells
(to 3%).

It should be noted that one subject of the study showed
no declines in aberrant T cell percentages, histology examination or CD8+
cells, and that the patient died 8 months after the stem-cell transplant.

The research team concluded that the promising short-term
results enjoyed by this small test group warrants a longer-term follow-up
to properly assess the significance of the findings.

Blood 2007;109:2243-2249.

health writer who lives in San Francisco and is a frequent author of articles
for Celiac.com.